Epinephrine Use in Endoscopic Ear Surgery: Quantitative Safety Assessment.

Alicandri-Ciufelli, Matteo; Molinari, Giulia; Beckmann, Sven; Caversaccio, Marco; Presutti, Livio; Anschütz, Lukas Peter (2020). Epinephrine Use in Endoscopic Ear Surgery: Quantitative Safety Assessment. ORL, 82(1), pp. 1-7. Karger 10.1159/000503725

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INTRODUCTION

The management of bleeding in exclusive endoscopic ear surgery (EES) is largely dependent on epinephrine use. However, to date its suitability and safety have not been assessed. The aim of the present study would be to assess the safety profile of topical application and/or local infiltrationof diluted epinephrine during EES regarding the intra- and postoperative periods. We hypothesize that epinephrine may be safely used during EES.

METHODS

Retrospective analysis of 90 EES cases performed at the University Hospital of Modena, Italy. Patient's charts and video recordings of the operations were assessed.

RESULTS

Epinephrine was used in all cases for hemostatic purposes as following: (1) diluted epinephrine (1:200,000) injection: mean 1.2 mL (range: 0-3.5) corresponding to 0.006 mg (range 0-0.018), and (2) topical application (1:1,000) directly in the surgical field: mean 7 cottonoids (range: 0-18) corresponding to mean 0.56 mg (range: 0-1.44). No major cardiovascular adverse effects were assessed. Only 2 intraoperative hypertensive events were recorded. One sensorineural hearing loss was observed in a case of cholesteatoma involving the stapes; no facial palsy occurred during the study period.

CONCLUSION

The combined use of local injection and topical epinephrine is a safe and effective strategy to control bleeding in exclusive EES, when used within the dilutions and quantities reported in this study.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)

UniBE Contributor:

Beckmann, Sven; Caversaccio, Marco and Anschütz, Lukas Peter

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1423-0275

Publisher:

Karger

Language:

English

Submitter:

Stefan Weder

Date Deposited:

22 Jan 2020 11:05

Last Modified:

09 Jul 2021 10:17

Publisher DOI:

10.1159/000503725

PubMed ID:

31743900

Uncontrolled Keywords:

Bleeding Efficacy Endoscopic ear surgery Epinephrine Safety

BORIS DOI:

10.48350/137956

URI:

https://boris.unibe.ch/id/eprint/137956

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